Contraceptive Uptake following Abortion in Rural Kenya

Paula Tavrow, University of California, Los Angeles
Mellissa Withers, University of California, Los Angeles
Kara McMullen, University of Colorado at Denver

BACKGROUND: We analyzed the impact of high quality, user-friendly, family planning services on post-abortion clients’ contraceptive uptake in rural Kenya. METHODS: Data were drawn from one private clinic’s records of 1,080 post-abortion clients. RESULTS: One-quarter of clients were below age 19 (mean age was 23). No client aged 10-18 reported prior contraceptive use, and only 7% accepted a method post-abortion, compared to 21% of clients aged 19-21 and 96% of clients aged 27-46. Adolescent contraceptive uptake was very low even though they had just experienced an unwanted pregnancy, and the physician strongly promoted contraception (with no added cost) during individual, confidential counseling sessions. Significant predictors of post-abortion contraceptive uptake were: having a child already, a previous termination, prior contraceptive use, and being older than 21. CONCLUSIONS: These findings suggest that availability, affordability, and youth-friendliness are not sufficient to overcome psycho-social barriers to contraceptive use among rural Kenyan adolescents.